Recovery from peripartum cardiomyopathy after treatment with bromocriptine.
Peripartum cardiomyopathy (PPCM) is a potentially devastating cause of heart failure that affects women late in pregnancy or in early puerperium. Recent findings showed that a 16 kDa fragment of prolactin may induce myocardial damage, and this offered a new option of treating PPCM by blocking prolactin with bromocriptine. We report on a 35-year-old woman with a twin gravidity who gave birth to two healthy boys at day 36/6 and developed a potentially fatal PPCM. Within 3 days since delivery she suffered from severe symptoms of heart failure (orthopnoea, pleural and pericardial effusion, reduced systolic function LVEF 15%). Bromocriptine 2.5 mg bid was added to standard heart failure therapy at day 6 after delivery, and within a week the patient recovered to NYHA functional class II. 2 months later she presented in a good state, NYHA class I, and MRI confirmed an LVEF of 60%. Balancing the potential side effects of bromocriptine against the very poor prognosis in severe PPCM our case supports the use of bromocriptine as a specific novel therapy.
Habedank
Dirk
D
Department of Cardiology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. dirk.habedank@charite.de
Kühnle
York
Y
Elgeti
Thomas
T
Dudenhausen
Joachim W
JW
Haverkamp
Wilhelm
W
Dietz
Rainer
R
D000328:Adult; D001971:Bromocriptine / Q000008:administration & dosage / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D006727:Hormone Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D049590:Postpartum Period; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000188:drug therapy*; D011256:Pregnancy Outcome; D020127:Recovery of Function
D006727:Hormone Antagonists; D001971:Bromocriptine